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New All-Payer Claims Database To Track Health Costs, Trends

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Rhode Island now has access to a new source of information about health care activities and costs. The All Payer Claims Database launches this week- "al...

Rhode Island now has access to a new source of information about health care activities and costs. The All Payer Claims Database launches this week- "all payer" meaning that it includes information from every health insurer, Medicaid, and Medicare. It's intended to help state agencies and researchers find out more about what works and what doesn’t in health care, where health care dollars are going, and track trends.

An all-payer claims database is a researcher’s dream. Rhode Island’s contains health insurance claim information on more than 800,000 patients for the past three years. The database could be used to hunt for trends in lead poisoning in children over time, for example. Or to query how many heart attack patients get readmitted to the hospital. It could also show how patients in a particular zip code manage diabetes.

The answers to those questions could guide policy changes in health care or help doctors. Gov. Gina Raimondo’s administration hopes to use the database to track efforts to improve Rhode Islanders’ health and rein in spending.

The data has been scrubbed of names, social security numbers and birth dates. Patients can opt out; insurers have been sending notices about how to do that. Researchers will be prohibited from publishing any studies involving 11 or fewer patients to protect privacy. State officials say only two percent of patients have opted out so far. The more patients in the database, they say, the more robust it will be.

In conjunction with the launch of the new database, called HealthFacts RI, the Executive Office of Health and Human Services released a report using the new tool about preventable emergency room visits. The agency says 60 percent of all emergency room visits are potentially avoidable, costing Rhode Islanders millions of dollars.

EOHHS says it will periodically release reports from the database to the public. Researchers will be able to query the database for a fee.

Rhode Island joins more than a dozen other states that already have all-payer claims databases. Maine and New Hampshire have allowed the public to access information about and compare health care prices from the database, according to the Robert Wood Johnson Foundation. 

A primer on all-payer claims databases from RWJF can be found here.

Federal grants helped fund the creation of the database. More federal funds will be used to operate the tool until, officials hope, it can pay for itself in research fees collected. 

As of 2013, several states were in the process of building all-payer claims databases.
As of 2013, several states were in the process of building all-payer claims databases.